Inner Image Counseling & Consulting Services

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

44SC05642500 Issued in NJ

Legal business name

INNER IMAGE COUNSELING & CONSULTING SERVICES

Practice address

90 Valley Way
West Orange, NJ 07052-5833

Phone

(186) 662-0232

NPI assigned

Apr 27, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Carolyn Davis-Cottle, LCSWNPI 1649640897

Title

Ceo

Phone

(866) 620-2323

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Carolyn Davis-Cottle

  • Clinical Social Worker
  • Maplewood, NJ
  • NPI 1649640897
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1461715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461715200000",
    "number": "1487009452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2130 MILLBURN AVE",
            "address_2": "SUITE D",
            "city": "MAPLEWOOD",
            "state": "NJ",
            "postal_code": "070403725",
            "telephone_number": "186-662-0232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 VALLEY WAY",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070525833",
            "telephone_number": "186-662-0232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNER IMAGE COUNSELING & CONSULTING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-27",
        "last_updated": "2016-04-27",
        "status": "A",
        "authorized_official_last_name": "DAVIS-COTTLE",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "18666202323",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NJ",
            "license": "44SC05642500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.